Dietary exclusion for childhood atopic dermatitis.

QUESTION: Atopic dermatitis (AD) (eczema) is very common in childhood. Parents are often concerned that food allergy plays a role in their child's eczema presentation and practise elimination diets for symptom control. Should I recommend that children with AD eliminate cow's milk or eggs from their diets? ANSWER: There is insufficient evidence about the benefit of eliminating cow's milk in unselected patients with AD. Some evidence suggests that egg elimination might benefit those children with AD who are suspected of being allergic to eggs and who are sensitized to eggs; however, more research is needed in this population to guide the use of food elimination. Prolonged elimination diets that are not physician guided also put patients at risk of nutritional deficiencies and failure to thrive, and might actually contribute to the development of clinical food allergy.